PRECISION APPLIANCE EMPLOYMENT APPLICATIONPlease complete the following application to be considered.

Personal Information

Name*

Prefix

First*

Last*

Suffix

Address*

Street Address*

Address Line 2

City*

State / Province / Region*

Postal / Zip Code*

Country*

Phone Number*

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Are you eligible to work in the United States?*

Yes

No

What date are you available to start?*

MM

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YYYY

EDUCATION:

Name and Address Of School - Degree/Diploma - Graduation Date*

Skills and Qualifications: Licenses, Skills, Training, Awards*

EMPLOYMENT HISTORY:

Present Or Last Position:

Name of Employer:*

Employers Address:*

Immediate Supervisor:*

Phone Number*

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Position Title:*

Start Date*

MM

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DD

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YYYY

End Date*

MM

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DD

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YYYY

Duties Performed*

Salary*

Input hourly wage, if not salaried.

Reason for Leaving:*

Previous Position

Employer:*

Address:*

Supervisor:*

Phone Number*

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Position Title:*

Start Date*

MM

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DD

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YYYY

End Date*

MM

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DD

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YYYY

Responsibilities:*

Salary*

Input hourly wage, if not salaried.

Salary expected if hired by Precision Appliance*

Reason for Leaving:*

May We Contact Your Present Employer?*

Yes

No

References: Please Provide 3 references
Name/Title Address Phone*

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.